Early Intervention In Childhood Setting Clare Messenger Implementation Advisor, The Early Intervention Foundation Insert Logo for Claire

What I will talk about The Early Intervention Foundation The importance of early intervention in early years Integrated systems for early years

WHO WE ARE… EIF launched on 4th July 2013 as a charity and a What Works Centre We promote Early Intervention to: Tackle the root causes of social problems Improve children’s life-chances, breaking the often intergenerational cycle of disadvantage Reduce the cost of failure to the taxpayer

WHAT WE DO…. Assess - what works – to determine both the best early interventions available and their relative value for money Advice - to commissioners, providers and investors on the best practical, evidence-based measures, enabling them to make the best choices to support children and families Advocate - for early intervention as a serious alternative to the more widespread expensive and ineffective late intervention

WHAT IS EARLY INTERVENTION Early Intervention is about getting additional, timely and effective support to children who need it – enabling children to flourish and preventing costly, long-term and damaging outcomes Programmes, Practices and Systems to prevent social cost and personal harm for children and young people, from conception to early adulthood. Early Years AND “Early” activity So what do we see as EI – there are many definitions and this is something that you will need to agree with yourselves and across partners We see Ei as …….. What we are going to talk about today is the importance of early intervention at an early age This of course also means supporting the parents and parents to be – so instantly we are talking over generations What we focus on….. Social and emotional well being Language and communication skills Self-management and control Mental health

WHY IS EARLY INTERVENTION IMPORTANT £70,000 – the cost of each child with untreated behavioural problems, 10 times the cost of children without behavioural problems £59,000 - the average annual cost for a young person to be placed in a young offenders institution £10m a day - the productivity loss to the state as a result of youth unemployment £2.9bn – the current total cost of children in care, half of which is spent with dealing with children who have been abused Source: Early Intervention: The Next Steps, report by Graham Allen MP, January 2011 So to remind ourselves of why EI is so important - these show some financial costs that are a result of not intervening early – much if these costs can be prevented

Early Brain Development Compelling evidence Emotional brain largely created in the first 18 months At birth: 10 trillion synapses - 200 trillion by age 3 (implies rapid learning via early life experience) Experience – hard wiring Embryo is affected by what the mother experiences eg DV Child’s development is affected by the responsiveness of their mother Parenting Attachment and attunement Works via neurons (brain cells) & synapses (connections) We know a lot more about the brain development now Compelling evidence of how important the eely years are in terms of maximising development

Why intervene at a young age? A child’s development score at just 22 months can serve as an accurate predictor of education outcomes at 26 years Vocabulary at age 5 has been found to be the best predictor of whether children who experienced social deprivation in childhood were able to escape poverty in later adult life. A study of boys assessed by nurses at age 3 as being ‘at risk’ found that they had two and a half times as many criminal convictions as the group deemed not to be at risk at age 21. Some 54% of the incidence of depression in women and 58% of suicide attempts by women have been attributed to adverse childhood experiences, according to a US study Many of the costly and damaging social problems in society are created because we are not giving children the right type of support in their earliest years and as they grow up and become parents themselves - Here are some things that we know happen if we don’t get the right support at the right time – many studies to show how important it is to get the right support for very young children and that if we don’t get this right then the implications are huge ………..

Poor communication skills impact on... Mental health Behaviour/vulnerability Educational achievement 40% of 7 to 14 year olds referred to child psychiatric services had a language impairment that had never been suspected Vocabulary at 5 a powerful predictor of GCSE achievement 2/3 of 7-14 year olds with serious behaviour problems have language impairment Criminality Disadvantage Cycle Employability Children from low income families lag behind high income counterparts by sixteen months in vocabulary at school entry 65% of young people in young offender institutions have communication difficulties 47% of employers say they can’t get recruits with the communication skills they need

What Helps? From birth, children’s learning results from their interaction with people around them, significantly affecting their later educational outcomes (Roulstone, 2011) Good quality early relationships and secure attachment enable a growing brain to become efficient, enhancing cognitive abilities (National Scientific Council on the Developing Child, 2011) The developing brain of the baby adapts itself to the quality of the relationship with parents, creating neural circuits that mirror his or her experiences (Belsky et al., 2011)

THE STILL FACE EXPERIMENT

What can we do? Integrated approach Universal preventive services Targeted EI for those families that need it, understand risk factors and route causes Evidence based programmes Think EI! , improving social and emotional development and communication skills Antenatal Universal health services, health visiting programme Children centres Early years practitioners Integrated approach

Family Nurse Partnership US evaluations have found: 48% reduction in verified cases of child abuse and neglect by the time the children were aged 15 56% reduction in A&E attendances for injuries and ingestions during child’s second year of life 28% relative reduction in all types of health care encounters during child’s first two years of life 79% relative reduction in the number of days that children were hospitalised with injuries or ingestions in child’s first two years of life FNP –just one example of an evidence based programme – uk studies are underway to look at the impact here and early results are reflective of the US studies

Incredible Years Providing Incredible Years to the 150 or o 3-year-olds at risk of conduct disorder would cost roughly £780,000 per year Most of those 150 children at risk of a conduct disorder in their third year of life will be calling on child protection, special education, foster care and youth justice provisions. Equivalent cost of taking 20 children into foster care for 1 year. If Incredible Years ensures that 21 of the 150 children do not require foster care it pays for itself, before taking account of any other improved outcomes. to help their babies feel loved, safe, and secure and encourage their babies’ physical and language development. The parenting group format fosters peer support networks and shared learning. Trained Incredible Years facilitators use video clips of real-life situational vignettes to support the training and stimulate parenting group discussions and practice exercises with their babies.

20 PIONEERING PLACES Blackpool Greater Manchester Blackburn with Darwen Cheshire West & Chester Croydon Dorset Essex Gateshead Hertfordshire Islington Lancashire Greater Manchester Newcastle Nottingham Poole Plymouth Solihull Staffordshire London Tri-borough Wiltshire & Swindon Worcestershire    We work with and through our 20 pioneer places – to learn, share good practice, encourage innovative ideas and test new ideas In addition to this we are developing a national programme of support – to enable the spread of learning and share evidence and reviews and tools as they are developed

SYSTEMS, PROGRAMMES & PRACTICE Family Nurse Partnership Multi-systemic Therapy Big Brothers Big Sisters Good Behaviour Game Incredible Years Functional Family Therapy Guiding Good Choices This emphasises that we are about all three PPS – that effective programmes should sit within an effective system in order to be most beneficial Our Places have put a great emphasis on finding how best to deliver in an effective system – this includes governance, commissioning and delivery

Integrated Systems in Early Years Commissioning Governance Strategic and operational targeting Integrated assessments and delivery Information sharing Evidence based programmes Best and promising practice for integrated structures Single front door Integrated MA teams Single management structure / professional supervision

Early Intervention in Action